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Legislative auditor to review HMO process for setting rates

Minnesota's legislative auditor says he will seek a new review of the rate-setting process for HMOs providing services to Medicaid patients.

The move comes a day after the human services commissioner told lawmakers that federal authorities are investigating the state's Medicaid program.
Auditor Jim Nobles said it is time to determine if the Department of Human Services is receiving the financial data it needs to oversee the managed care plans and whether the department is using that data effectively.

"And that process is very complex, definitely the Department of Human Services has a central role in that," Nobles said. "We've examined it in the past and had some concerns and issues we've raised, and I think it's a good time to go back and look at it again."

Nobles would like his office to investigate more deeply than it did in a similar audit in 2008. The review would probably begin in March or April, and review several years, he said. A report would be delivered likely in the next legislative session.

"Given the complexity and the depth we want to go would probably take us probably six to eight months to conduct it," Nobles said.